Review of Outcomes After Diagnosis of Malignancy in Kidney Transplant Patients: Unos Database

H. Patel¹, N. Agrawal¹, R. Gupta¹, P. Geetha², A. Abdul Razzack³, F. Cardarelli¹

¹Transplant Nephrology, Beth Israel Deaconess Medical Center, Boston, MA, ²Nephrology, Beth Israel Deaconess Medical Center, Boston, MA, ³Medicine, Dr. NTR University of Health Sciences, Vijaywada, India

Meeting: 2021 American Transplant Congress

Abstract number: 1249

Keywords: Graft survival, Kidney transplantation, Malignancy, Mortality

Topic: Clinical Science » Organ Inclusive » Non-PTLD/Malignancies

Session Information

Session Name: Non-PTLD/Malignancies

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: Malignancy is the third major cause of death among transplant recipients. Among the transplant recipients, Patient and kidney transplant outcomes after the diagnosis of malignancy are not well described. With this study we review incidences and outcomes of Colorectal, Lung, PTLD, and Renal malignancy after transplant.

*Methods: It is a retrospective study of patients of who received transplant from January 2000 to December 2018 using UNOS/OPTN database. Incidence of each malignancy have been measured at 5 years and 10 years of transplant. Kaplan Meier curve was used for time to event analysis (graft and Patient outcomes). Additionally, we sought to identify the causes of graft failure among these recipients.

*Results: Total 12,764 (5.5%) of patients have suffered malignancy (non-squamous/basal cell skin carcinoma) after transplant. During first 5 years of transplant, Incidence of Colorectal, Lung, PTLD, and Renal malignancies were 2.99, 9.21, 15.61 and 8.55 per 10,000 person years, respectively. Rate of graft failure was 10.3%, 7.6%, 19.9%, and 18.8% respectively among these patients.

*Conclusions: In this study, kidney transplant recipients who are diagnosed with lung malignancy have the lowest patient and graft survival, compared to PTLD, colorectal and renal malignancy. PTLD has the highest incidence rate in the first 5 years of transplant; however, between 5-10 years from transplant lung malignancy has the highest incidence followed by PTLD, renal and colorectal malignancies. The most common cause of graft failure in this patient population is chronic rejection, followed by malignancy complications and acute rejection.

Graft and Patient survival rate and time after malignancy
Malignancy	Death censored graft failure	Diagnosis to graft survival time (days)	Total number of deaths	Time from Diagnosis to death (days)
Colorectal	51 [10.3%]	478 [163 – 1292]	304/494 [61.5%]	254 [68 – 781]
Lung	108 [7.6%]	199 [45 – 733]	1190/1416 [84%]	151 [45 – 373]
PTLD^#	386 [19.9%]	471 [118 – 1226]	950/1936 [49.1%]	175 [41 – 585]
Renal	210 [18.8%]	466 [100 – 1169]	396/1115 [35.5%]	392 [95 – 1089]

To cite this abstract in AMA style:

Patel H, Agrawal N, Gupta R, Geetha P, Razzack AAbdul, Cardarelli F. Review of Outcomes After Diagnosis of Malignancy in Kidney Transplant Patients: Unos Database [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/review-of-outcomes-after-diagnosis-of-malignancy-in-kidney-transplant-patients-unos-database/. Accessed May 9, 2025.

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